- •Ergonomics includes support for physical, cognitive, and organizational factors
- •Hand therapy ergonomic approaches can be applied at micro, meso, and macro levels
- •There is a dearth of evidence for use of ergonomics in upper extremity osteoarthritis
- •Contextualized and lifestyle approaches best support carryover in daily life
- •Promoting self-efficacy is a vital component for long-term effects of ergonomics
Invited literature review
Arthritis is the leading cause of disability in adults, and research shows that people living with arthritis experience work instability, loss of independence, financial difficulties, and overall decreased quality of life. Current nonpharmacological treatments can be beneficial for short term relief; however, the evidence on these long-term treatments is limited. Ergonomic modifications have been used in the workplace to address musculoskeletal conditions to ensure proper fit of one's environment, and research shows that these modifications can decrease pain and injury and increase work productivity. A broader perspective on ergonomic approaches may be important to supporting individuals with arthritis within hand therapy.
Purpose of the Study
This review proposes an expanded perspective on ergonomic approaches within hand therapy and explores published literature to identify potential benefits of applying ergonomic approaches for individuals with upper extremity arthritis.
A systematic search and screening process was conducted to identify articles that implemented an ergonomic approach for the support of individuals with upper extremity osteoarthritis or rheumatoid arthritis.
A total of 34 articles described interventions that employed ergonomics including task-based or general ergonomics (n = 17), contextualized supports (n = 8), or holistic, lifestyle approaches (n = 9). Only one study focused solely on individuals with osteoarthritis, whereas interventions for individuals with rheumatoid arthritis showed positive outcomes across these categories. Situational learning, building of patient self-efficacy, and development of new habits and routines are vital for carryover and implementation to support performance in daily life.
There is an opportunity for hand therapists to extend the scope of interventions provided as part of an ergonomic approach to supporting patients. Specifically, therapists can consider use of emerging technologies and telehealth that promote contextualization and follow-up for long-term outcomes.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Therapy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Randomized prospective study of a work place ergonomic intervention for individuals with rheumatoid arthritis and osteoarthritis.Arthritis Care Res. 2012; 64: 1527-1535
- Self-management approaches for osteoarthritis in the hand: a 2× 2 factorial randomised trial.Ann Rheum Dis. 2015; 74: 108-118
- Vital signs: prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2013–2015.MMWR Morb Mortal Wkly Rep. 2017; 66: 246
- Effects of an educational–behavioral joint protection program on people with moderate to severe rheumatoid arthritis: a randomized controlled trial.Clin Rheumatol. 2007; 26: 2043-2050
- A crossover trial evaluating an educational–behavioural joint protection programme for people with rheumatoid arthritis.Patient Educ Counsel. 1999; 37: 19-32
- The effectiveness of joint-protection programs on pain, hand function, and grip strength levels in patients with hand arthritis: a systematic review and meta-analysis.J Hand Ther. 2019; 32: 194-211
- A proof-of-concept study of the “employment and arthritis: making it work” program.Arthritis Care Res. 2008; 59: 1647-1655
- One year effects of a workplace integrated care intervention for workers with rheumatoid arthritis: results of a randomized controlled trial.J Occup Rehab. 2017; 27: 128-136
- Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review.Arthritis Res Ther. 2011; 13: 1-13
- Six and 12 months' effects of individual joint protection education in people with rheumatoid arthritis: a randomized controlled trial.Scandinavian J Occup Ther. 2012; 19: 360-369
- Joint protection: enabling change in musculoskeletal conditions.International Handbook of Occupational Therapy Interventions. Springer, New York2015: 607-618
- A first introduction to ergonomics Chapter 1: The industrial use of ergonomics.Appl Ergon. 1969; 1: 26-32
- Ergonomics Research Society.Br Med J. 1950; 1: 1009
- Cognitive ergonomics: it's all in the mind.Ergonomics. 1997; 40: 1170-1182
- Ergonomics in organizational design and management.Ergonomics. 1991; 34: 743-756
- Managing the Risks of Organizational Accidents. Routledge, London1997 (doi:10.4324/9781315543543, 2016. [Accessed 5 July 2022])
- The discipline of human factors and ergonomics.Handbook Human Factors Ergon. 2012; 4: 3-37
- Whitfield D Chapter 2: General framework and workstation analysis.Appl Ergon. 1969; 1: 33-41
- Macroergonomics: Theory, Methods, and Applications. CRC Press, Boca Raton2002
- Clasification of ergonomics levels for research.(Paper presented at:)in: IOP Conference Series: Materials Science and Engineering. 2019
- Mesoergonomics, the missing part of the macroergonomics and microergonomics approach.J Eng Design Technol. 2021;
- On the safety hierarchy and hierarchy of controls.Am J Mech Eng. 2020; 8: 61-68
National Institute for Occupational Safety and Health. Hierarchy of controls. Available at: https://www.cdc.gov/niosh/topics/hierarchy/default.html. Accessed April 11, 2022.
- “Hierarchy of Controls”: providing a framework for addressing workplace hazards.AJN Am J Nurs. 2003; 103: 104
- Expanding the paradigm of occupational safety and health: a new framework for worker well-being.J Occup Environ Med. 2018; 60: 589-593
- Total Worker Health® 2014–2018: the novel approach to worker safety, health, and well-being evolves.Intl J Environ Res Public Health. 2019; 16: 321
- Integrating micro- and macro-ergonomics.Proc Human Factors Ergon Soc Annual Meeting. 1998; 42: 964-968
- Scoping studies: towards a methodological framework.Intl J Soc Res Methodol. 2005; 8: 19-32
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Ann Intern Med. 2009; 151 (W264): 264-269
- Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial.Arthritis Care Res. 2002; 47: 44-49
- Clinical applicability of an educational-behavioural joint protection programme for people with rheumatoid arthritis.British J Occup Ther. 2002; 65: 405-412
- Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis—randomized clinical trial.Rheumatol Intl. 2018; 38: 343-351
- The ergonomic assessment tool for arthritis: development and pilot testing.Arthritis Care Res. 2008; 59: 1495-1503
- Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol).BMC Med Inf Decis Making. 2014; 14: 1-7
- Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial.BMC Musculoskeletal Disord. 2017; 18: 1-15
- Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy.Arthritis Care Res. 2009; 61: 1522-1530
- A program for improving energy conservation behaviors in adults with rheumatoid arthritis.Am J Occup Ther. 1987; 41: 102-111
- One-year outcomes of a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis.Rheumatology. 2001; 40: 1044-1051
- The long-term outcomes from a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis.Clin Rehab. 2004; 18: 520-528
- Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial.Patient Educ Counsel. 2011; 82: 42-48
- Effectiveness of a self-management program for joint protection and physical activity in patients with rheumatoid arthritis: a randomized controlled trial.Intl J Nurs Studies. 2021; 116103752
JHT Read for Credit
Quiz: # 865
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The study design is
- b.literature review
- c.case series
- # 2.How many articles specifically addressed ergonomic factors with OA of the upper extremity
- # 3.Nora confesses that she
- a.hates her job and her boss
- b.frequently overdoses on her NSAIDs
- c.has difficulty remembering the joint protection ideas she was taught in therapy
- d.didn't relate well to her hand therapist and consequently has been noncompliant to her home program
- # 4.The authors are advocates for
- a.soft tissue massage
- b.telehealth sessions
- c.early surgical intervention
- d.daily meditation
- # 5.The authors suggest that often hand therapists are not utilizing all the ergonomic considerations available to them in case management
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Published online: July 22, 2022
Accepted: June 10, 2022
Received: April 11, 2022
© 2022 Elsevier Inc. All rights reserved.